A: I can understand your apprehensions about having a second child. In my experience, many women with your type of obstetric history have complications with the next pregnancy. Preterm labor recurs around 30 percent of the time, for example. And caring for a child while coping with a complicated pregnancy adds extra demands and stresses, and requires the participation of a well-established support network.

You absolutely need to talk in detail to a specialist about your first pregnancy. You should discuss the risk of complications in your next pregnancy, and find out if there are any ways you can reduce your chances of further complications. For example, could increasing your weight prior to pregnancy help you maintain normal weight during pregnancy? Would taking mineral supplements lower your chance of having pregnancy-induced hypertension?

If you think you obstetrician is too busy to discuss these issues with you, get a copy of your medical records and consult with a perinatologist, an obstetrician who specializes in high-risk pregnancies. You and your husband should discuss your concerns with an expert before you conceive. You may choose to schedule more than one consultation: one with your current OB and another with a perinatologist. Once you have received appropriate counseling, you and your husband can decide whether the benefit of having another child outweigh the risks of another pregnancy.